Teeth whitening consent form pdf

Teeth whitening consent form pdf

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The In-Office Whitening. Significant whitening can be achieved in the vast majority of cases, but the results cannot be guaranteed. applied to my teeth for two or three minute sessions, with an INFORMED CONSENT FOR TOOTH WHITENING TREATMENT Smile Cliniq provides this information to give you insight into tooth whitening. These are seldom serious enough to discourage you from having your teeth whitening but should be considered in making a ision to have the treatment. Teeth are variable in color and this Informed Consent for Philips Zoom Tooth Whitening Treatment. Tooth Sensitivity When done properly, the whitening will not harm your teeth or gums Color stability varies and you should wait at leastweeks after whitening is completed for additional cosmetic procedures As with any treatment there are benefits and risks. TW At-Home Teeth Whitening Information/Informed Consent General Information Teeth Whitening is designed to lighten the color of your teeth. The Whitening System is a state-of-the-art technology designed to lighten the color of your natural teeth. This information has been given to me so that I can make an informed ision about having 2,  · Teeth whitening (TW) is an effective, non-invasive elective dental procedure designed to lighten, whiten & brighten your teeth to their optimum natural brightness! General Information. atment involves using the gel to produce maximum whitening results in the shortest possible time. ___ During the procedure the whitening gel will be. ,  · This information is to help you make an informed ision about having tooth whitening. The risk involves the continued use of the peroxide solution for an extended period of time Teeth whitening, like any other treatment, has some inherent risks and limitations. INTRODUCTION. During the procedure, the whitening gel will be applied to your teeth for three (3) minute sessions All forms of tooth whitening, have some risks and limitations. Your cooperation and understanding of this material is necessary as we strive to achieve the best results for you. Tooth whitening is designed to lighten the color of your teeth. Significant whitening can be achieved in TEETH WHITENING CONSENT FORM Patient Name: _____ Date:_____ FACTS The active ingredient in teeth whitening is carbamide peroxide in a You understand that Boutique Whitening treatments are not capable of lightening artificial teeth, caps, crowns, veneers or porcelain, composite or other restorative materials INFORMED CONSENT FOR WHITENING. Complications that can occur in professional tooth whitening are generally infrequent though, and are usually minor in nature. You should take as much time as you wish to make the ision in File Size: KB In-Office Whitening is a procedure designed to lighten the color of my teeth usinga hydrogen peroxide gel. When done properly, the e Whitening is a procedure designed to lighten the color of my teeth using a hydrogen peroxide gel. Candidates for Teeth Whitening Just about anyone is a candidate for teeth whitening, but the following points Procedure: Venus Chairside professional tooth whitening is a procedure designed to lighten the color of your teeth using a hydrogen peroxide mixture. I understand that the results of whitening are variable and that individuals respond differently. The In-Office Whitening treatment involves using the gel to Tooth Whitening Informational Consent Form. If you have any questions about these potential risks/problems, please ask us before signing this consent form. It produces maximum whitening results in the shortest possible time with minimum sensitivity. Risks: All forms of health treatment, including tooth whitening, have some risks and limitations Tooth Whitening Informational Consent Form General Information Tooth whitening is designed to lighten the color of your teeth. The benefit is that teeth can be whitened fairly quickly in a simple manner. It is performed under the Teeth Whitening Informed Consent.